Aortic Angiosarcoma: A Rare Cause for Leaking Thoracic Aneurysm

Abstract

Primary malignant tumours of the aorta are rare. They present with aneurysm formation, arterial occlusion, and embolic phenomenon. We report the case of a 56-year-old man whose initial presentation and investigations lead to emergency endovascular stenting of a descending thoracic aneurysm with a contained leak. Initial response was favourable, yet the patient presented again with worsening symptoms. The circum-aortic haematoma expanded by 50% on subsequent imaging, but no endoleak was identified. When altered bone marrow signal was identified on magnetic resonance imaging, the possibility of malignancy was considered. A metastatic skin lesion was then biopsied, which demonstrated morphological and immunohistochemical features consistent with metastases from a pleomorphic sarcoma of the aorta.

Editor's Choice – Management of Descending Thoracic Aorta Diseases

“…295 Endovascular exclusion can be offered only for compassionate use when repetitive tumour embolic events occur.…”

Angiosarcoma of the Descending Aorta, Diagnostic Difficulties

“…About 140 cases of primary malignant neoplasia of the aorta have been described in the literature, with the first being documented by Brodowski in 1873 1, 3…”

“…The symptoms and radiological appearance of these tumors are often non-specific. The diagnosis is often established after resection of the tumor 3, 4. The most common histological entities that have been described are sarcomas without classification 4 …”

Angiossarcoma mimetizando endoleak tardio pós-reparo endovascular de aneurisma de aorta infrarrenal: relato de caso

“…There are several articles describing angiosarcoma involving large vessels, especially the aorta, and causing a range of complications because of its high invasivity: mimicking thoracic aortic aneurysm 10 ; rupture of aneurysms of the thoracic aorta 11 or abdominal aorta 12 ; hypertension, anemia and visceral ischemia 13 ; and mimicking an infection of a prosthesis 14 ; among others. Development of sarcomas has also been documented in the literature in association with implantation of foreign bodies in humans and in animal models.…”